Further psychometric evaluation of the Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire: Practical implications in healthcare settings.

The sample was pragmatic, drawn from Swedish workplaces already involved with occupational health services between 2015 and 2018, mainly medical wards, so it may not represent other countries, professions, or current workplaces. The study did not analyse item fit to the model, which matters when scores are summed across items. The questionnaire has only been tested in healthcare contexts, not in other parts of the labour market. Some items had problems: item 7 had disordered categories even after grouping, and item 22 appeared across factors rather than behaving as a single all-embracing item.

Do not read this as evidence that SMET improves patient care or that the red-yellow-green grouping is always better. The study tests questionnaire properties in Swedish healthcare workplaces, not clinical outcomes, and grouping reduced precision for environmental items and question-respondent matching.